Coronary arteriovenous fistulas are no longer rare. They should be suspected whenever there are atypical continuous murmurs over the sternum. Aortography and coronary arteriography reveal the origin of the anomalous coronary arteries and show their termination, most often in the right heart structures.Whether to operate is an individual decision. In some instances, because cardiac failure may result from coronary arteriovenous fistula, early operation is advised.Aortography and coronary arteriography usually delineate the problems to be encountered, and the availability of bypass techniques makes surgery even more successful.